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ELECTRONIC FETAL MONITORING AND NEUROLOGIC OUTCOMES.

Despite the widespread use of electronic fetal monitoring, randomized trials have failed to show that it is better than auscultation at lowering perinatal mortality. This study suggests that electronic monitoring does not prevent poor neurologic outcomes after premature delivery.

Shy and colleagues randomized women in premature labor to receive either electronic monitoring throughout labor or auscultation at close intervals. The authors assessed neurologic, psychomotor, and mental development over an 18- month follow-up period in the surviving infants who weighed 1750 g or less at birth (82 in the electronic-monitoring group and 91 in the auscultation group). There were no differences in mean developmental scores between the two groups. Moreover, the incidence of cerebral palsy was significantly higher in the electronically monitored group (20 percent vs. 8 percent).

The reasons for this disappointing result are unclear. One clue may be that the time from onset of abnormal fetal heart rate to delivery was longer in the electronically monitored patients. Whatever the reasons, electronic fetal monitoring has again failed to improve perinatal outcomes.

— ASB

Published in Journal Watch General Medicine March 9, 1990

Citation(s):

Shy KK et al. Effects of electronic fetal-heart-rate monitoring, as compared with periodic auscultation, on the neurologic development of premature infants. N Engl J Med 1990 Mar 1 322 588-593.

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